Download PDF
CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2021; 08(03): 210-212
DOI: 10.1055/s-0040-1713559
Case Report

Inherited Factor XII Deficiency—What Is the Real Concern for Neuroanesthesiologist: Bleeding or Clotting

Mouleeswaran Sundaram
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Sonia Bansal
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Rohini M. Surve
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Factor XII deficiency is a rare disorder that can complicate the perioperative management of a patient. Factor XII plays an important role in the activation of intrinsic pathway of coagulation; the deficiency, therefore, results in prolongation of activated partial thromboplastin time (aPTT). This aPTT prolongation is expected to cause increased bleeding during surgery. However, on the contrary, in vivo isolated factor XII deficiency is associated with increased risk of thromboembolism (this risk being higher than the risk of bleeding). We report the perioperative management of a patient with factor XII deficiency who underwent cervical vertebral fusion (C1–C2) for atlantoaxial dislocation.

Keywords

factor XII - surgery - bleeding - thromboembolism


Publication History

Article published online:
11 June 2020

© 2020. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Kessler C. Coagulation factor deficiencies. In: Goldman L, ed. Cecil Textbook of Medicine. Twenty-first edition. Philadelphia, USA: Saunders Company 2000: 1004-1012
  • 2 Halbmayer WM, Haushofer A, Schön R. et al The prevalence of moderate and severe FXII (Hageman factor) deficiency among the normal population: evaluation of the incidence of FXII deficiency among 300 healthy blood donors. Thromb Haemost 1994; 71 (01) 68-72
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Barbosa ACN, Montalvão SAL, Barbosa KGN. et al Prolonged APTT of unknown etiology: a systematic evaluation of causes and laboratory resource use in an outpatient hemostasis academic unit. Res Pract Thromb Haemost 2019; 3 (04) 749-757
    CrossrefPubMedGoogle Scholar
  • 4 Dragoumanis C, Vretzakis G, Vogiatzaki T. Perioperative management of a patient with severe factor XII deficiency. Eur J Anaesthesiol 2004; 21 (10) 829-830
    CrossrefPubMedGoogle Scholar
  • 5 Pauer HU, Burfeind P, Köstering H, Emons G, Hinney B. Factor XII deficiency is strongly associated with primary recurrent abortions. Fertil Steril 2003; 80 (03) 590-594
    CrossrefPubMedGoogle Scholar
  • 6 Chaudhry LA, El-Sadek WYM, Chaudhry GA, Al-Atawi FE. Factor XII (Hageman Factor) deficiency: a rare harbinger of life threatening complications. Pan Afr Med J 2019; 33: 39
    CrossrefPubMedGoogle Scholar
  • 7 Bick RL, Haas S. Thromboprophylaxis and thrombosis in medical, surgical, trauma, and obstetric/gynecologic patients. Hematol Oncol Clin North Am 2003; 17 (01) 217-258
    CrossrefPubMedGoogle Scholar